tci Medicare Compliance & Reimbursement - 2006 Issue 35

INDUSTRY NOTES: PE-RVU Changes Could Cut Major Procedures By 10 Percent

Plus:  OIG uncovers $20 million in Medicare overpayments for radiology services.If the Centers for Medicare & Medicaid Services (CMS) goes ahead with plans to change how it calculates practice expense relative value units (PE-RVUs), it could create winners and losers among physicians, the Medicare Payment Advisory Commission (MedPAC) said Sept. 9. The move to a new "bottom up" system would increase PE-RVUs by 5 percent for evaluation & management visits but decrease them the same amount for imaging services. Major procedures would see a shocking 10-percent PE-RVU drop, and "other procedures" would lose about 4 percent. Tests would...

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